Should people faced with an incurable terminal illness, with less than six months to live, be able to receive prescription medication to painlessly end their own suffering? The question affects real people facing terrible end-of-life dilemmas.
As a clergyman, I accompanied two of my parishioners through the final stages of their lives when they chose to stop eating and drinking rather than endure the alternative. Margaret was diagnosed with an inoperable brain tumor that would inevitably destroy her mind and personality long before her heart stopped beating. Jim had ALS, which left him completely paralyzed, progressively shutting down bodily functions while leaving the higher cognitive abilities intact. With the support of their families and physicians, both chose to stop hydration, dying of thirst over the course of several days. Thanks to palliative care, the process was not agonizing, but not pleasant, either. Both would have preferred a quicker and more merciful exit, but state law didn’t give them that option.
Residents of Massachusetts may soon have more choices. After receiving a petition bearing 79,626 signatures last December, the House Joint Committee on the Judiciary is now considering a ballot initiative titled the “Death With Dignity Act.” If voters approve in November, individuals like Jim and Margaret who are terminal with no hope of recovery will soon be able to ask a doctor for a dose of kindness. Safeguards insure that the patient be of sound mind, under no coercion, repeating the request on three occasions, separated in time by an interval of at least fifteen days, properly witnessed by impartial, disinterested observers.
If the experience of states like Oregon and Washington which have passed similar legislation are any guide, the right to self-administer euthanasia is rarely exercised. In the first fourteen years after its passage, just 401Oregonians took advantage of the law. Given any reasonable chance for a viable quality of life, few people elect to hasten their own demise. But knowing the option is available has given peace of mind to thousands of others, for there truly are some fates worse than death.
I empathize with individuals like Jim and Margaret, because for almost one year I lived tethered to a dialysis machine. Three times each week, my blood circulated through an artificial kidney in a process that took hours and left me physically drained. I survived and eventually received an organ transplant. But from firsthand experience, I can also understand the decision some others have made (mostly elderly or unable to find a suitable donor) to simply unplug the device.
Should anyone in such a situation be kept alive against their will? Virtually all medical ethicists recognize the patient’s right to refuse treatment—even a treatment like dialysis that might save or prolong one’s life. How different is that from the right that Jim and Margaret were requesting, to leave the world through their own volition? Physician assisted “suicide” is the wrong term for an act that is really a final assertion of autonomy, dignity and self-control. Neither Jim nor Margaret were cases of suicide, for the choice they faced was not whether to live or die, but only whether death would be more or less cruel, degrading and prolonged.
Whose life is it, anyway? There can be only one answer for me and members of my church like Jim and Margaret, who want to make their own decisions right down to the very end.